HomeMy WebLinkAbout1996-008194 - re-roof PERMIT
f CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 R J T t :jpq
Permit Number:
Crystal Bay, Minnesota 55323
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(612) 473-7357 Date Issued: 07;"j A F,
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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-Total Fee: $ DateReceived:
Date Approved:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BE STARTED
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: 685 Old Crystal Bay Rd. Orono, MN ZIP: 55356
NAME OF OWNER: ISD #278 PHONE: (home)
(work)
MAILINGADDRESS: 685 Old Crystal Bay Rd. CITY: Lona Lake, MN ZIP: 55356
CONTRACTOR: Granite City Roofing, Inc. PHONE: 320-253-4441
MOBILE PHONE/PAGER:
MAILINGADDRESS: PO lox 1482 CITY:St. Cloud ZIP: 56302
STATE LICENSE: #
ARCHITECT/ENGINEER: RHA Architects PHONE: 320-656-0787
MAILINGADDRESS: 2925 1st St. So. CITY:St. Cloud, MNZIP: 56301
NAME: Ron Hruerrlinn REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
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Move Remodel/Alteration _X Land Alteration
PROPOSED WORK(describe indetail): Removal of old roof, replace with new roof
STORIES: 1 SQ. FEET OF EACH FLOOR: 16590
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ / j Sod
I hereby apply for a building permit and I acknowledge that the information above is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City
and with the State Building Code; that I understand this is not a permit and work is not to start
without a permit; and that the work will be in accordda4ce with the approved plan.
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APPLICANT'S SIGNATURE: &eDATE: '� Z
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data' stored or to be stored shall be as set forth in this section.
Subd.2. Information required to be given individual. An individ asked to supply private or confidential data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within a collecting'state agency,political subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data,(c) y known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities autho ed by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigative data,pursuant to ection 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue may lace the notice reguired under this subdivision in the individual income tax or property tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsi le authority,an individual shall be informed whether he is the subject
of stored data on individuals,and whether it is classified as public,private or c nfidential. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires,shall be informed of the content
and meaning of that data. After an individual has been shown the private data informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this section is pe ing or additional data on the individual has been collected or created.
The responsible authority shall provide copies of the private or public data upo request by the individual subject of the data. The responsible authority
may require the requesting person to pay the actual costs of making,certifyin ,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if imdtediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an additional'' ve days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shall notify in riting the responsible authority describing the nature of the disagreement.
The responsible authority shall within 30 days either: (a)correct the data fo nd to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreeme t is included with the disclosed data.
The determination of the responsible authority may be appealed ursuant to the provisions of the administrative procedure act relating to
contested cases.
DATA PRIVAC ADVISORY
In accordance with M.S. 13.04,Subd.2, "Rights of sub ects of data",we would like to inform you that your request
for a permit or license from the City of Orono or any of it departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to de�ermine your qualification for the permit or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to process
the permit or license.
4. If your requested permit or license requir Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04 'available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle Last
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Address
City State Zip Phone
I understand my rights as stated above.
Signature
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